FLEXIBLE FITNESS: Double-jointed: What does it mean?

Tuesday

Jul 18, 2017 at 11:35 AMJul 18, 2017 at 11:35 AM

By: Ashley Sougley and Annie Squires/ Daily News Correspondents

Can your thumb touch your wrist? Do your elbows bend backward when you raise your hand in the classroom? Do your knees bend backward when you’re waiting in line for a coffee? If these things happen to you then you may be hypermobile. You might have also heard this called “double-jointed.” What does this mean? It means a person whose joints are able to move beyond a normal range of motion.

What causes joint hypermobility? Your joints are held together by muscles and connective tissue. Connective tissue is made up of tendons and ligaments. When the connective tissue stretches too much, allowing for excessive joint mobility, the joint is considered to be hyper-mobile.

Who might have hypermobility? A gymnast may have a hypermobile spine from too many back bends. A runner may have hypermobility after too many ankle sprains. A volleyball player may have a hypermobile shoulder from too many overhead serves. As one can see, hypermobility can be caused from a variety of movement patterns or injuries. In other cases, joint hypermobility may occur in many joints throughout the body and be associated with certain genetic conditions that require further testing.

Individuals with hypermobile joints tend to be more prone to injury, experience more pain, take longer to recover from injury, and have poor body awareness. So how are these individuals evaluated and treated in physical therapy?

The focus of physical therapy treatment is strengthening the muscles around the hypermobile joints. Strengthening muscles will provide support and stability as well as help protect the joints. Another important focus of physical therapy is assessing functional movements. If the legs or hips are involved then walking, standing, squatting, and climbing the stairs will be looked at. If the joint or joints affected are in the arms then it is important to look at movements like push-ups, lifting, carrying, or reaching overhead. It is important to look at these movements so your physical therapist can give you the best treatment possible, and train the joints to move correctly. Stretching is not a recommended treatment used to treat hypermobile joints. While it may provide temporary relief from pain it will usually make those joints more hypermobile and cause more pain.

If you tend have painful and mobile joints, it is best to be evaluated by your doctor and physical therapist. A physical therapist can identify appropriate strengthening and stability exercises to give your joints optimal support. You could also try a quick assessment on yourself called the “Beighton Scale.” Give yourself one point for each of the following: one point if can you place your palms flat on the floor with your legs straight, one point for each elbow that bends backwards more than 10 degrees, one point for each knee that bends backwards more than 10 degrees, one point for each thumb you can bend to touch your forearm, and one point per pinky finger that bends backwards beyond 90 degrees. If you score high on this scale, it is likely you have some degree of hypermobility.

Annie Squires PT, MSPT, OCS. is Clinical Specialist at Spaulding Outpatient Center in Framingham. She specializes in a variety of orthopedic diagnoses for adult patients.

Ashley Soughley PT, DPT, NCS is a physical therapist clinical specialist at Spaulding Outpatient Center in Framingham who specializes in treating individuals with neurological and vestibular diagnoses, in addition to treating individuals with Ehlers-Danlos Syndrome and joint hypermobility.